This space reserved for office use Submit in duplicate to Filing Fee No fee authorized to receive service of process for the entity named below submits this rejection of appointment 1 The name of the ID: 896097
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1 The attached form is drafted to meet min
The attached form is drafted to meet minimal statutory filing requirements pursuant to the relevant code This space reserved for office use. Submit in duplicate to: Filing Fee: No fee authorized to receive service of process for the entity named below, submits this rejection of appointment. 1. The name of the entity for which the undersigState the name of the represented entity as currently shown in the records of the secretary of state.
2 2. The file number issued by the secre
2. The file number issued by the secretary to the entity is: 3. The undersigned certifies that thentity named above on the date on which the registered agent filing in which the person is named as The undersigned signs this document subject to the penalties imposed by law for the submission of a materially false or fraudulent instrument. Date: Signature of person rejecting appointment as agent Printed or typed name of person rejecting appointment as agent Form 428 Print Reset